Comprehensive Comparison of Axial Length Measurement With Three Swept-Source OCT-Based Biometers and Partial Coherence Interferometry

PURPOSE: To compare axial length measurements (and failure rate) of three swept-source optical coherence tomography (SS-OCT)-based biometers: IOLMaster 700 (Carl Zeiss Meditec, Jena, Germany), OA-2000 (Tomey, Nagoya, Japan), and Argos (Movu Inc., Kornaki, Japan) to those provided by a partial coherence interferornetry (PCI)-based optical biometer (IOLMaster v5.4 [Carl Zeiss Meditec]). METHODS: A total of 119 patients (171 eyes) undergoing cataract surgery were enrolled. Axial length was measured with the four biometers in a random order. Chi-square analysis was used to determine whether statistically significant differences in success rates were found between biometers. Within-subject standard deviation (S-w), test-retest repeatability (TRT), coefficient of variation (CoV), and intraclass correlation coefficients (ICCs) were calculated to analyze the intraobserver repeatability. Bland-Altman plots were used for agreement assessment. RESULTS: Axial length measurements were successfully measured in 166 eyes (97.08%) with the IOLMaster 700, 166 eyes (97.08%) with the OA-2000, 170 eyes (99.42%) with the Argos, and 138 eyes (80.70%) with the IOLMaster v5.4. Chisquare analysis indicated a significant difference in the failure rate between PCI- and SS-OCT-based biometers (P < .001). Intraobserver repeatability for the IOLMaster 700, OA-2000, and Argos showed excellent repeatability with low TRT (0.03, 0.06, and 0.05 mm, respectively), Low CoV (0.04%, 0.10%, 0.07%, respectively), and high ICC (1.000, 0.999, and 1.000, respectively). The Bland-Altman 95% limits of agreement were as narrow as 0.09 mm, indicating excellent agreement among the three SS-OCT biometers and the PCI biometer. CONCLUSIONS: The three SS-OCT biometers showed a significantly higher success rate for axial length measurement than the IOLMaster v5.4 in various lens opacities. These SS-OCT biometers are likely to become the gold standard for axial measurement.